Web App Technology for Boys and Parents: Improving HPV Vaccine Uptake

总统癌症咨询委员会和疾病控制中心呼吁重新努力， 促进人类乳头瘤病毒（HPV）疫苗接种，包括为青春期男孩接种疫苗，因为 这种新疫苗的使用率仍然低得惊人。目前，只有不到15%的青春期男孩 接受HPV疫苗;因此，这一人群中的大多数仍然存在口咽，肛门和阴茎的风险 癌的许多父母仍然不相信HPV疫苗的安全性和有效性，因此有效， 需要提供无障碍的信息，以改进关于这种疫苗的决策。青春期男孩的父母也 与青春期女孩相比，对HPV疫苗接种有不同的担忧， 采取宣传措施，促进男孩接种疫苗。干预措施还需要解决 少数民族人口和英语不是第一语言的人口面临的独特挑战。一种新型 数字干预将产生并评估其改善HPV疫苗结果的能力。 具体地，将创建执行类似于应用的移动的响应web应用（“移动的web应用”）。 移动的应用程序，但运行在各种计算平台上，从个人台式机和笔记本电脑到 最新的智能手机和平板电脑。移动的Web应用程序内容将针对父母和青少年 生活在新墨西哥州的11-13岁男孩，新墨西哥州是一个少数民族占多数的人口， 西班牙裔，白人和美洲原住民。具体目标是：（1）认真、系统地制定 适用于智能手机、平板电脑和个人电脑的移动的网络应用程序（BoyVac）， 传播创新原则，提供有关HPV疫苗采用的有针对性的信息， 青少年男性及其父母，特别是少数群体青少年及其父母; 2）实施一项 对BoyVac移动的网络应用程序干预对HPV疫苗的影响进行全面而严格的测试 通过随机疗效试验（BoyVac与常规和习惯护理）的采用结果; 3）检查 组件内移动的Web应用程序使用与疫苗结果之间的剂量反应关系 分析.采用分组随机前后测控制设计，招募1800对 来自30家儿科诊所的父母和青少年男孩（每家诊所n=60名父母和男孩）， 设想新墨西哥州，在新墨西哥州健康科学中心的大学的最佳实践计划 儿科系。父母将在基线、3个月随访和9个月随访时接受调查 和记录的HPV疫苗接种的男孩将从诊所的医疗记录，在9- 月随访。分析将检验以下假设：1）干预组中更多的11-13岁男孩 （BoyVac移动的网络应用程序）将采用HPV疫苗比男孩在平时和习惯护理比较 组和2）采用HPV疫苗将介导的理论介质之间的改善 父母在干预相比，通常和习惯的照顾比较组。

The President's Cancer Advisory Board and the Centers for Disease Control have called for renewed efforts in promoting vaccination for Human Papillomavirus (HPV), including vaccination for adolescent boys, because the uptake of this new vaccine remains alarmingly low. Currently, less than 15% of adolescent boys have received the HPV vaccine; thus, most of this population remains at risk for oropharyngeal, anal, and penile cancers. Many parents remain unconvinced of the safety and effectiveness of HPV vaccines, so effective and accessible messaging to improve decision-making on this vaccine is needed. Parents of adolescent boys also have different concerns about HPV vaccination than for adolescent girls, creating a need for unique health communication interventions to promote vaccine uptake among boys. Interventions also need to address the unique challenges of minority populations and populations for whom English is not the first language. A novel digital intervention will be produced and evaluated for its ability to improve HPV vaccine outcomes. Specifically, a mobile responsive web application (“mobile web app”) will be created that performs similar to a mobile app but runs on a variety of computing platforms from personal desktop and laptop computers to the latest smart phones and tablet computers. Mobile web app content will be targeted to parents and adolescent boys aged 11-13 years living in New Mexico, a majority-minority population with large proportions of Hispanics, Whites, and Native Americans. The specific aims are to: 1) carefully and systematically develop a mobile web app (BoyVac) for smart phones, tablet computers, and personal computers that will utilize Diffusion of Innovations principles to provide targeted information concerning HPV vaccine adoption to adolescent males and their parents, particularly minority adolescents and parents; 2) implement a comprehensive and rigorous test of the impact of the BoyVac mobile web app intervention on HPV vaccine adoption outcomes via a randomized efficacy trial (BoyVac v. usual and customary care); and 3) examine the dose-response relationships between mobile web app usage and vaccine outcomes within a components analysis. A group-randomized pretest-posttest controlled design will be implemented, recruiting 1800 pairs of parents and adolescent boys from 30 pediatric clinics (n=60 parents and boys per clinic) affiliated with the Envision New Mexico, a best practices program at the University of New Mexico Health Sciences Center's Department of Pediatrics. Parents will be surveyed at baseline, a 3-month follow-up, and a 9-month follow-up and records HPV vaccination adoption for the boys will be obtained from the clinics' medical records at the 9- month follow-up. Analyses will test the hypotheses that 1) more 11-13 year old boys in the intervention group (BoyVac mobile web app) will adopt the HPV vaccine than boys in the usual and customary care comparison group and 2) adoption of HPV vaccine will be mediated by improvements in theoretical mediators among parents in the intervention compared to the usual and customary care comparison group.